Antimicrobials
Ciprofloxacin

Ciprofloxacin

High
Excellent

Dosing

General Information

Pseudomonas and other gram negative infections of urinary tract, bone/joint, abdomen and other sites

NOT first line for uncomplicated UTIs

Monitor QTc in patients with increased risk

  • QTc prolongation
  • Dysglycemia
  • Tendinopathy and tendon rupture
  • GI upset
  • Rash
  • Retinal detachment
  • CNS toxicity including confusion, psychosis
  • Weakness exacerbation in myasthenia gravis

CYP1A2 inhibitor - Multiple interactions possible.

QTc prolongation - Increased risk with other agents that prolong QTc.

Divalent & trivalent cations including Al, Ca, Fe, Mg (antacids, dairy products, iron supplements, some enteral feeds) - Decreased absorption

Cyclosporine - Increased levels of cyclosporine

Warfarin - Increased INR

Methadone - Lowered seizure threshold

  • Intravenous ciprofloxacin: only for patients unable to take oral medication. Bioavailability ~70-80% (80% of 500 mg PO = 400 mg absorbed, which is equal to IV dose)

Oral Ciprofloxacin Administration

  • Avoid dairy products, antacids, and other sources of divalent cations (Ca, Fe, Mg, Al, Zn) which can chelate ciprofloxacin and prevent absorption (administer ciprofloxacin 2 hours before or 6 hours after)
  • Must hold continuous tube feeding 2 h before and 2 h after administration

Antimicrobial class: Fluoroquinolone

Pregnancy category: C

Average serum half life: 4 hours

Urine penetration: Therapeutic

Lung penetration: Therapeutic

CSF penetration: Moderate (IV only)

Biliary penetration: Therapeutic